01 November 2007

Apnoea treatment vs depression

The use of a breathing treatment called continuous positive airway pressure may improve depressive symptoms in patients with obstructive sleep apnoea.

The use of a breathing treatment called continuous positive airway pressure may improve depressive symptoms in patients with obstructive sleep apnoea, according to a study in the Journal of Clinical Sleep Medicine.

Obstructive sleep apnoea is a common problem in which patients stop breathing for short periods during sleep. It occurs when soft tissues in the back of the throat relax and temporarily block the airway. The condition is frequently seen in individuals who are obese and those who snort.

With continuous positive airway pressure (CPAP), the patient wears a special mask that continuously blows air into the throat, preventing the tissues from collapsing.

Patients regularly depressed
"The significance of our findings," Dr Daniel J. Schwartz said, "is that symptoms which might otherwise be ascribed to depression - feelings of sadness, discouragement about the future, feelings of excessive personal failures, perceived decreases in self-confidence, a sense of being overly self-critical, the inability to derive pleasure from things, and even suicidal (thoughts) - may at times be attributable to obstructive sleep apnoea, an easily treatable medical illness."

People with obstructive sleep apnoea are often depressed, Schwartz and Dr Gillian Karatinos of The Sleep Centre at University Community Hospital, Tampa, note in their report.

In an earlier study of 50 obstructive sleep apnoea patients, 32 of whom had symptoms of depression at enrolment, the researchers noted a marked improvement in standard depression test scores after initiation of in-home CPAP therapy.

Sustained improvement
Their latest assessment of these patients, conducted about 1 year after the initiation of CPAP, shows that ongoing CPAP therapy is associated with sustained improvement in depressive symptoms.

"It is possible," Schwartz told Reuters Health, "that at least some patients being treated with antidepressant medications - those whose symptoms are due to obstructive sleep apnoea - might be better served with CPAP therapy."

The investigators say it remains "incompletely understood" how CPAP therapy lessens depressive symptoms. - (Reuters Health)

Read more:
Apnoea disrupts brain waves
Sleep apnoea troubles kids


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Michael Simpson has been a senior psychiatric academic, researcher, and Professor in several countries, having worked at London University in the UK; McMaster University in Canada; Temple University in Philadelphia, USA.; and the University of Natal in South Africa.

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